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Individual

DR. JOHN GIRARDOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 N BERTEAU AVE, ELMHURST, IL 60126-2966
(630) 833-1400
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036082692
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036082692
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036082692
STATE LICENSE
IL
Enumeration date
08/22/2006
Last updated
09/20/2024
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